Lead Business Analyst

Job Title: Lead Business Analyst

Duration: 6 Months

Location: Remote: Must be able to work EST

Healthcare Domain Must

Project Summary

looking for a Lead Business Analyst who will support the implementation of GuidingCare (HealthEdge product) care management platform for Utilization Management Care Management and Appeals and Grievances. Currently CareFirst is moving their Maryland Medicaid and DSNP lines of businesses and uses 2 separate products. CareManager (HealthEdge product) for Utilization Management and Care Management and OnBase (Highland product) for Appeals and Grievances. Both of these are scheduled to be moved to GuidingCare in the middle of June

Essential Functions

The Lead Business Analyst will be responsible for requirements gathering process documentation and SOP development of CMS requirements related to Medicaid and DSNP.

Top Five Skills Required

• 8 years of Business Analysis experience.
• Handson experience supporting requirements gathering and process documentation related to DSNP and Medicaid lines of business.
• Experience with Utilization Management Care Management and Appeals and Grievance clinical platforms. (CareFirst is currently using CareManager for Care Management and Utilization Manamgent OnBase for Appeals and Grievances and migrating all to GuidingCare experience with any of the 3 is required.)

Nice to have skills

• Jira experience
• Experience supporting a clinical platform migration related to Utilization Management Care Management and Appeals and Grievances.

Education

Bachelors